As Linda Glennie, our Director of Research, Evidence and Policy, retires we asked her to look back on nearly 26 years at Meningitis Research Foundation, reflecting on all that has been achieved and what has changed within meningitis research and policy-making during that time.

Covering everything from vaccine introductions to genomics, COVID to Counting the Costs, she tells us what she is proudest of and what she’d like to see happen in the next ten years.

How did you start your career in meningitis research?

It was entirely an accident. I was a coordinator on a research project before a role came up to be a medical information officer at Meningitis Research Foundation (MRF) in September 1996. The charity at that time was very small but there were a lot of meningitis cases in the UK, so the demand was great.

What has been the biggest meningitis research or policy development that you have seen in your time at MRF?

On the policy side, the biggest and most far-reaching is the fact we now have a Global Road Map.

In a case setting, getting the MenC vaccine introduced has been fantastic and has had far reaching consequences around the world. The UK led the way in introducing it, providing information that has been so useful for other countries on the benefits of using conjugate vaccines.

What MRF did at that time to raise awareness of cases rising generally, cases rising in teenagers and young adults, drawing attention to outbreaks, and the needs and limitations of public health measures was very important. We’ve always said prevention is key because the disease comes on so quickly, with early medical attention critical.

In your time at MRF what has been the achievement you’re proudest of?

It has to be our contribution to getting the MenB vaccine introduced: we did a great deal of work to lay the ground work through Counting the Costs, working very closely with our communications and advocacy team, and with our membership of families living with the consequences of this disease on the Meningitis Matters campaign.

During the 90s there had been an evident and rising burden in the UK. By the time we had a vaccine available for MenB in 2013 cases weren’t so high. Politicians might have thought it was ‘job done’, that it had gone away. But the disease naturally cycles and, unless you have vaccines that are going to stop it, then any kind of respite you have is temporary – there is nothing to stop it coming back.

Getting the MenB vaccine approved for introduction was a huge moment of triumph because it was against what I think would have happened if we hadn’t made the representations we did. The Joint Committee on Vaccination and Immunisation (JCVI) had already published their interim statement, saying it wouldn’t be cost effective to introduce the vaccine at any price and calling for further evidence. We had a lot of work to do to try and get that decision changed. If you look at the particular elements we argued and the things that made the difference they were what we put forward.

One of the things that’s made me love working here is the fact we’re constantly in contact with people, because we run a helpline, because we run events, because we fundraise with people affected. Bringing that perspective to the world of research and policy making is unique, has made a big difference, and made MRF a very satisfying place to work.

What developments would you like to see in the next 10 years in meningitis research?

Getting a Group B Strep vaccine is the area where it has been imminent for so long and there still isn’t one. There are things that should be done to improve the situation now but really only a vaccine is ever going to make a huge difference.

We still need better MenB vaccines – what we have is brilliant but we always knew it wouldn’t cover all the strains of MenB and it doesn’t give indirect protection, so it doesn’t stop transmission. In the case of pneumococcal infection, the fact we have vaccines is excellent and they are saving lives world-wide but they only protect against a portion of the strains that can cause meningitis and other life-threatening infections. That story isn’t finished - I hope the Global Road Map will make a difference and that by 2030 we’ll be much further ahead.

Across the globe, we need better surveillance of what is out there so we know if vaccines are working. And even once we have vaccines there are still all these people who have been affected. So we do need to have better systems to look after people, so they can get the support and care they need. It’s not only medical - it’s also the social and educational impact on people and their families.

What can people working in the field of meningitis research learn from COVID?

In some ways COVID has done some of our job for us – previously it was a struggle to get people to understand the difference between transmission and illness. For example, people harbouring the germ but being asymptomatic is something we all understand now.

It could also help unlock what we’ve been pushing for in the area of pathogen genomics. So much of what countries have been able to do, rapidly coming up with public health measures or vaccine development has been down to the availability of genomic information. For the future, it seems likely for COVID we’ll end up with vaccines that are tailored to the bug and the way it’s changed.

People can really see the difference genomic information has had: knowing the difference between Alpha, Delta, Omicron, has made a difference to understanding what their risks, are and to countries’ policies on travel, and COVID measures. That helps make the case for why increasing representation in pathogen genome sequencing for meningitis is important and why openness and having a real-time window into what is happening can be transformative for diseases that aren’t yet fixed, like meningitis.

Can you tell me how the team is changing?

Claire Wright is becoming our Head of Evidence and Policy and Liz Rodgers is becoming our Head of Research. So much of what we have achieved to date is down to what Claire and Liz have brought to their current roles at MRF; it’s great their leadership potential has been recognised. Claire has amazing insight in analysing what is going on with estimation of burden for instance - without Claire we would never have got the quantitative angle of Counting the Costs. Liz led the consensus paper that has fostered the formation of the Global Meningitis Genome Partnership. They have the grasp of the issues we’re dealing with and I know MRF is in good hands.

Can you sum up your time at MRF?

I’ve had the opportunity to meet the greatest minds in infectious diseases that are out there. We’ve managed to attract such brilliant people to MRF, so I’ve working alongside great people. It has been a huge privilege, an obsession almost, to have a role where you feel you’re making a difference in the world, one where you get positive feedback from the people you’re supporting directly.